| NPI | 1033403712 |
|---|---|
| Former Name | BEVERLY ANN WEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL PTA22603) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE001683L) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2011-05-31 |